PQRS: Why 2013 Matters

-->March 22, 2013Billing & Compliance Alerts

    PQRS: Why 2013 Matters 
    By Justin Vaughn, M.Div, CPC
    Director of Compliance

    3/22/2013

    This is just a reminder to our clients that the 2013 version of the PQRS program is a bit different from all previous iterations.  There are still 3 anesthesia measures to report; there is still a small bonus one can earn; there is still a reporting threshold that must be met; but something significant has changed.

    In previous years, the PQRS incentive program was voluntary.  Beginning this year, the program has become mandatory.  That is, for the first time, a financial penalty will be attached to non-participation.  This penalty—a 1.5% downward adjustment in your total annual Medicare allowable—will be imposed in 2015, but it is based on 2013 reporting.

    Again, all this is a reminder of what we’ve previously published.  We are nearing the end of the first quarter of 2013, so now may be a good time to review where you stand as an individual provider and as a group.  Are you participating?  Are you consistently sharing PQRS data with Medac via the medical record, etc.?  For those of you who have never participated in PQRS, you still have time to begin the process in order to (a) satisfactorily meet the 50% annual reporting threshold, (b) earn the 0.5% bonus, and (c) avoid the 1.5% 2015 penalty.  If you have questions concerning the PQRS program, please contact your Medac compliance liaison or practice manager, or visit the CMS website.

    The information presented herein reflects general information that is current as of the date it was first published.  In light of changes that may occur in the health care regulatory and compliance environments, the author’s presentation of this information might become outdated.  Please check with your individual legal and/or compliance advisor(s) prior to taking any significant actions based upon the information and advice presented.